Acupuncture can be successful in many chronic medical problems

Management of chronic musculoskeletal pain offers many occasions in which therapeutic modalities can be combined. A physical therapist experienced in myotherapy can extend the impact of an acupuncture treatment directed at relaxation of contracted muscles and facial tension patterns. The conventional spray and stretch triggers point infiltration, and transcutaneous electrical nerve stimulation techniques of physical medicine combine well with acupuncture therapy. Osteopathic manipulative therapy and its subspecialty of cranial therapy also can be productively combined with the musculoskeletal applications of acupuncture. Hatha yoga postures assist patients with biomechanical rehabilitation and maintenance of results, and the breathing exercises assist with relaxation and stress reduction. Movement therapy such as the Alexander and Aston approaches also can be useful adjunctive activities during rehabilitation.

With chronic medical problems, the traditions of herbal therapies and homeopathic remedies can be usefully combined with acupuncture treatments. Chinese herbal formulae, when prescribed according to the classical patterns of disharmony of internal organs, can serve as protopharmaceutical substrates to enhance and prolong the effects of acupuncture treatments. Herbal formulae can accomplish lasting change or maintenance that cannot be achieved with needles alone.

Homeopathic remedies are generally used in low potency form to treat acute problems, middle potency form to treat chronic medical problems, and high potency form to treat problems that have a core psycho emotional disturbance. These remedies can be used to specify and enhance the acupuncture treatments and have capability in high potency to effect enduring changes in the patient's emotional configuration. It is sometimes necessary to work in collaboration with a psychiatrist or psychotherapist who is both sensitive to the acupuncture process and can serve in a guiding role for the patient.

In many countries, acupuncture is performed by physician as well as non-physician practitioners. The practice of acupuncture is included in the scope of a physician's medical or osteopathic license, and no regulations or restrictions are imposed on medical practitioners. Others like acupuncture Australia require physicians practicing acupuncture either to demonstrate evidence of participation in training programs of 200 to 300 hours or simply to register with the board of medicine with evidence of formal training. From these loose regulations of physician practitioners, it is clear that the degree of acupuncture training and experience among physicians varies from place to place and individual to individual. However, the World Health Organization has adopted guidelines on basic training for physician and non-physician providers, standards for safe practice, and clinical indications for acupuncture. The training guidelines reflect the minimum hours expected in most member nations; 2500 hours for non-physician acupuncturists and 200 hours for physicians.

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